By Jason D. Churchill, PA-C, Founder, Premier Senior Living and Memory Care, Carterville and Marion, IL

Figures verified against Illinois HFS and Illinois Department on Aging materials, September 2026

Does Medicaid Pay for Memory Care in Illinois?

The monthly rate for memory care is often the first number families look up, and it is usually higher than they expected. The next step is usually looking for a program that can help pay for it. Medicare seems like the natural place to start, because it has covered your parent’s doctor visits and hospital stays. When Medicare turns out not to pay for memory care, the next question is whether Medicaid will.

Illinois has a Medicaid program that pays for assisted-living-style care, including dementia care in certain settings. The program does not pay for room and board, and it is only available in approved communities. Qualifying requires gathering financial records and completing a care needs assessment.

Quick answer: does Medicaid pay for memory care in Illinois?

Sometimes. Illinois Medicaid may help pay for certain care services for people who qualify, primarily through the state’s Supportive Living Program. However, Medicaid generally does not pay for room and board in a memory care community. Eligibility, community participation, and care needs all affect what coverage may be available.

What surprises families about paying for memory care

Families asking this question have usually just learned one or more of the following:

• Medicare and Medicaid sound similar, but they are separate programs with separate rules
• Medicare does not pay the monthly cost of living in memory care
• Illinois Medicaid can help with care services, but not with room and board
• Not every memory care community accepts Medicaid, so qualifying for Medicaid does not guarantee a place that accepts it
• Medicaid approval takes time, so the best time to start is before savings run low

Each point is explained below using Illinois rules and figures.

6 things families should know about Medicaid and memory care

1. Medicaid eligibility requirements

Illinois Medicaid for older adults runs through the Aid to the Aged, Blind and Disabled category. Eligibility is based on both income and countable assets. According to the Illinois Department on Aging, the 2026 asset limit is $17,500, and it does not increase for a couple. The 2026 monthly income standard is $1,330 for one person and $1,803 for two.2

Not every asset counts toward the limit. A primary home, one vehicle, and personal belongings are generally excluded, and the home equity limit for 2026 is $752,000.2 If one spouse needs care and the other stays home, spousal protections apply. The 2026 spousal impoverishment resource allowance is $162,660, and the community spouse maintenance needs allowance is $4,066.50 per month.2

These figures are based on federal poverty level percentages, and the Illinois Department of Human Services posts exact figures each April.2 Confirm any number you are planning around before you rely on it.

2. What Medicaid may cover

Illinois built the Supportive Living Program as an alternative to nursing home care. The state obtained a federal waiver so Medicaid can pay for services it does not usually cover. These services include personal care, homemaking, laundry, medication assistance, social and health activities, recreation, and care available around the clock for both scheduled and unscheduled needs.1

The Supportive Living Program also includes dementia care. Illinois certifies some Supportive Living sites specifically as dementia care settings, where residents receive increased oversight, additional nursing assessments, and more activity programming.5 The number of these settings is limited, and a certified dementia care setting near you may not have an opening when your parent needs one.

3. What Medicaid may not cover

Medicaid does not pay for room and board in Supportive Living. Illinois states that the resident is responsible for paying the cost of room and board where they live.1 The resident pays that cost from their own monthly income.

Medicaid coverage is also limited to certain settings. Supportive Living communities are apartment-style, with a private bathroom and a kitchen or kitchenette. Small residential care homes and many private-pay assisted living and memory care communities are not part of the program. A community has to be approved and certified to accept Medicaid through Supportive Living, and many are not. Premier Senior Living and Memory Care is not part of the Supportive Living Program and does not accept Medicaid.

4. Illinois waiver programs

Supportive Living operates through a Home and Community Based Services waiver approved by the federal Centers for Medicare and Medicaid Services. The waiver allows Medicaid to pay for assisted-living-style services for people who would otherwise need a nursing home.5 Nursing home coverage is a separate Medicaid pathway with its own rules.

For program questions or a list of approved communities, call the Bureau of Long Term Care at the Illinois Department of Healthcare and Family Services (HFS) at 844-528-8444 or 217-782-0545.5

5. Why financial planning matters

Many families pay privately at first and apply for Medicaid later, after savings have been spent down. Paying privately first can work if someone in the family tracks how many months your parent’s savings and income will cover. Calculate that number before you tour. The number tells you how long your parent could stay in a community that does not accept Medicaid, and whether a move might be needed later.

Giving money or property to relatives can cause problems with Medicaid eligibility. Medicaid reviews asset transfers during a look-back period. Moving money to a relative to qualify can lead to a penalty period when Medicaid will not pay for long-term care. Talk to an elder law attorney before you transfer any money or property.

6. When to start the application process

Start the Medicaid application process earlier than you think you need to. The Illinois Department of Human Services decides financial eligibility. The application requires records of income and assets going back several years. A needs assessment must also confirm that your parent needs a nursing home level of care. Gathering records takes longer than filling out forms. Start while your parent can still help you find the paperwork.

How do Medicare, Medicaid, and private pay compare for memory care?

Medicare does not pay for memory care. Medicaid may pay for care services in approved settings. Private pay covers the full cost at any community that accepts it.

 

Medicare states on its long-term care page that it does not pay for long-term care, because most long-term care is not medical care.3 Some families mistake a short-term Medicare benefit for memory care coverage. Medicare does cover up to 100 days in a skilled nursing facility after a qualifying inpatient hospital stay.4 That benefit covers recovery after a hospital stay and stops after 100 days at most.

How can families find out whether a parent qualifies?

These five steps show whether your parent is likely to qualify and where Medicaid could be used.

• Review financial qualifications. Add up countable assets and monthly income, and compare them against the current Illinois limits.
• Understand Illinois requirements. Confirm the current figures with the Department of Human Services rather than relying on a number you read online, including the figures in this article.
• Gather documentation. Bank statements, tax returns, deeds, insurance policies, and records of any transfers going back several years.
• Explore available programs. Ask the HFS Bureau of Long Term Care which Supportive Living communities near you are certified as dementia care settings, and whether they have openings.
• Speak with care providers. Ask every community directly whether it accepts Medicaid, because many do not, and find out before your family becomes attached to a particular community.

Financial planning checklist

Work through these six reviews before you assume memory care financial assistance is or is not available to your family.

• Income review: Social Security, pension, annuities, and any other monthly sources
• Asset review: accounts, investments, property, and anything transferred in recent years
• Insurance review: long-term care policies, life insurance with cash value, and Medicare supplements
• Benefits review: VA benefits, which are separate from Medicaid and often overlooked
• Medicaid documentation: statements and records assembled before you need them
• Long-term care planning: a conversation with an elder law attorney before moving any money

Important to know

Premier Senior Living and Memory Care is a private-pay community and does not accept Medicaid. Some Illinois communities participate in Medicaid-funded programs such as the Supportive Living Program, and families may wish to explore those options if Medicaid coverage is an important part of their planning. Our goal is to help families understand the available choices and determine which option best fits their situation.

Where can southern Illinois families get free help?

Illinois runs aging services through regional Area Agencies on Aging.6 Families in Williamson County, which includes both Carterville and Marion, are served by the Egyptian Area Agency on Aging, whose office is on East Plaza Drive in Carterville. It covers the 13 southernmost counties in the state and provides information, referral, and free caregiver training and support.7

Calling the Egyptian Area Agency on Aging is free, and the agency can help families understand which programs may be available before they apply.

Questions about paying for memory care in southern Illinois?

Here is when a call to us makes sense:

• You are trying to understand what Medicaid will and will not cover.
• You are comparing what private pay covers with what a waiver program provides.
• You want a small home rather than a large community.
• You need to talk it through with someone who has worked in senior care for years.

Premier Senior Living and Memory Care is a private pay community. We do not accept Medicare or Medicaid, and we tell families that in the first conversation. If your family needs Medicaid to pay for care, ask the HFS Bureau of Long Term Care about certified Supportive Living dementia care settings near you. We can help you prepare questions to ask them.

If private pay is an option your family is considering, we would be glad to show you how our memory care services work in our homes. We run two homes: a 7-room home in Carterville in the heart of a 43-acre nature sanctuary, and a newly opened 16-room home in Marion in the countryside. Meals are cooked in our own kitchen, care plans are built around each resident and updated as needs change, and our caregivers are trained in dementia care. No one here is ever just a number.

You can read more about our services and our story, or call (618) 201-5654 to schedule a visit.

Frequently asked questions

Does Medicaid pay for memory care in Illinois?

Illinois Medicaid can pay for care services in approved Supportive Living communities, but it does not pay for room and board. Some of these communities are certified as dementia care settings. The Supportive Living Program is the Medicaid waiver that provides this coverage. The community has to be approved to participate, and many private memory care communities are not. Premier Senior Living and Memory Care is private pay and does not accept Medicaid.

Does Medicare pay for memory care?

Medicare does not pay for memory care as a place to live. Medicare continues to cover doctor visits, hospital stays, prescriptions, and therapy after a move. Medicare also covers up to 100 days in a skilled nursing facility after a qualifying inpatient hospital stay.4 Room, board, and daily supervision are not Medicare benefits.

What is the difference between Medicare and Medicaid?

Medicare is federal health insurance based on age or disability, and most people 65 and older qualify regardless of income. Medicaid is an assistance program based on income and assets, administered by the state. Medicare covers medical care. Medicaid is the program that helps with long-term care, and only for people who meet the financial requirements.

Can families combine multiple payment sources?

Yes. Many families pay for memory care with more than one source of money. Common sources include Social Security and pension income, savings, proceeds from selling a home, a long-term care insurance policy, and VA benefits for veterans or surviving spouses. Families who later qualify for Medicaid usually apply after private funds have been spent down.

How do I apply for Medicaid benefits?

You apply for Illinois Medicaid through the Illinois Department of Human Services, which decides financial eligibility. A needs assessment then confirms whether your loved one needs a nursing home level of care. For questions about the Supportive Living Program specifically, the HFS Bureau of Long Term Care can be reached at 844-528-8444 or 217-782-0545.5 Gather your documentation before you start, because collecting financial records usually takes the longest.

What if my loved one does not qualify?

If your loved one does not qualify for Medicaid, the usual option is paying privately, at least for a period. Before assuming private pay is the only option, check long-term care insurance policies, VA benefits, and whether Medicaid’s spousal protections apply. An elder law attorney can review your parent’s situation and explain any options under Medicaid rules. If private pay is the only option, calculate how many months your parent’s funds will cover. Ask each community you tour what happens if those funds run out.

A note on this article

Important: Every family’s situation is different. This article is intended to provide general information for families researching how to pay for care and should not be considered legal, financial, tax, or medical advice. Medicaid eligibility depends on factors such as income, assets, care needs, and program availability, and Illinois program rules may change over time. Before making any decision based on eligibility requirements or benefit levels, confirm current information with the Illinois Department of Healthcare and Family Services, the Illinois Department of Human Services, or a qualified elder law attorney. All figures and program information reflect the sources cited below as of the publication date.

About the author

Jason D. Churchill, PA-C, is the founder of Premier Senior Living and Memory Care. A physician assistant, he spent 15 years caring for residents inside senior communities across southern Illinois before opening his own. Premier operates two small homes: a 7-room home at 6703 Grand Road in Carterville and a 16-room home at 8380 Worleys Mill Road in Marion, serving families throughout Williamson County and the surrounding region.

Premier Senior Living and Memory Care is a private pay community and does not accept Medicare or Medicaid.

Sources

[1] Illinois Department of Healthcare and Family Services.
“Illinois Supportive Living Program.”
https://hfs.illinois.gov/medicalprograms/slf.html
https://hfs.illinois.gov
Accessed September 2026.

[2] Illinois Department on Aging.
“2026 Illinois Medicaid Income Standards and Resource Limits.”
https://ilaging.illinois.gov/content/dam/soi/en/web/aging/ship/documents/medicaidincomeassetlimits.pdf
https://ilaging.illinois.gov
Accessed September 2026.

[3] Medicare (U.S. Centers for Medicare and Medicaid Services).
“Long-Term Care.”
https://www.medicare.gov/coverage/long-term-care
https://www.medicare.gov
Accessed September 2026.

[4] Medicare (U.S. Centers for Medicare and Medicaid Services).
“Skilled Nursing Facility (SNF) Care.”
https://www.medicare.gov/coverage/skilled-nursing-facility-care
https://www.medicare.gov
Accessed September 2026.

[5] State of Illinois.
“Illinois Medicaid department announces new dementia care settings in the Supportive Living Program.”
https://www.illinois.gov/news/press-release.20553.html
https://www.illinois.gov
Accessed September 2026.

[6] Illinois Department on Aging.
“Illinois Area Agencies on Aging.”
https://ilaging.illinois.gov/forprofessionals/aaa-list.html
https://ilaging.illinois.gov
Accessed September 2026.

[7] Egyptian Area Agency on Aging.
“Home.”
https://egyptianaaa.org/
https://egyptianaaa.org
Accessed September 2026.